Intranasal Dexmedetomidine versus Oral Paracetamol as a pre-anesthetic medication in children undergoing adeno-tonsillectomy: A Randomized Clinical Trial.

Document Type : Original Article

Authors

1 Department of Anesthesia , Faculty of medicine, Benha university, Benha, Egypt

2 Lecturer of Anaesthesia and Intensive Care Faculty of Medicine – Benha University

3 Department of Anesthesia, Faculty of Medicine, Benha University, Benha, Egypt

Abstract

Background and aim: Anesthetic premedication with dexmedetomidine helps to alleviate anxiety, reduces analgesic need, and prevents unfavorable postoperative psychological events. In addition, it helps in rapid inhalational induction and oro-tracheal intubation.
This study aims to assess the premedication efficacy of oral paracetamol and intranasal dexmedetomidine regarding alleviating anxiety and tolerance to separation from the parents.
Methods: This prospective, randomized, double-blinded, comparative clinical trial was done on 86 children ASAI or II of either sex who were scheduled for adeno-tonsillectomy and received either oral paracetamol or intranasal dexmedetomidine. The primary goal of our trial was to evaluate anxiety level and assess tolerance to separation from the parents; this was assessed by the modified Yale scale. Our secondary goals were perioperative hemodynamic parameters and SPO2, which were followed up in the preoperative period and after receiving the drug. Intraoperatively, the anesthesiologist recorded child's heart rate and MAP. Postoperatively, parents' satisfaction was assessed.
Results: Preoperative anxiety score showed no significant difference between both groups. Also, baseline HR, MAP, and SpO2 were comparable. No significant differences were noted at 10 and 20 minutes after drug administration in all vitals (P > 0.05). However, 30 minutes later, till the operation ended, the blood pressure and heart rate were significantly higher in group P than in group D. No significant difference was reported between both groups regarding SpO2(P > 0.05).
Conclusions: Oral paracetamol is similar to intranasal dexmedetomidine in reducing preoperative anxiety. As a result, paracetamol is a good substitute for dexmedetomidine.

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